1. Field of the Invention
The invention is directed to a method of treating men suffering from chronic nonbacterial prostatitis with a selective estrogen receptor modulator (SERM) compound, an aromatase inhibitor and/or an antiestrogen.
2. Description of Related Art
Prostatitis is an inflammatory disorder of the prostate, which close to 50 percent of all men suffer at some stage of their life. Chronic nonbacterial prostatitis involves inflammation of the prostate gland and commonly affects men of all ages. It can cause chronic pelvic pain syndrome (CPPS), problems urinating, including discomfort and pain, increased frequency and urge, or problems emptying the bladder.
In a suitable hormonal milieu, with androgens present, chronic nonbacterial prostatitis may progress to prostate overgrowth (benign prostatic hyperplasia (“BPH”)), and to prostate cancer.
Selective estrogen receptor modulators (“SERMs”) are compounds binding to estrogen receptors in different tissues but exercising either antagonistic or agonistic effects. Compounds like tamoxifen, toremifene, raloxifene, lasofoxifene, bazedoxifene, ospemifene and fispemifene are typical SERMs. They share some common characteristics such as being antiestrogenic in breast cancer and estrogenic in bone, whereas in other organs they show varying degrees of estrogenic or antiestrogenic properties. In the urinary tract, the antiestrogenic properties seem to prevail.
Experimental models have shown that selective estrogen receptor modulators (SERMs) may be useful for treating or preventing lower urinary tract symptoms (LUTS). A method for the treatment or prevention of lower urinary tract symptoms, including nonbacterial prostatitis, with SERMs is fully disclosed in U.S. patent application Ser. No. 10/454,823, incorporated herein by reference.
U.S. Pat. No. 5,972,921, incorporated herein by reference, teaches treatment of urethral sphincter dysfunction, which causes LUTS by aromatase inhibitors.
The basis for treating urinary tract symptoms with SERMs or aromatase inhibitors is the observation that an increase of the ratio of estradiol to testosterone results in the development of urethral sphincter dysfunction, which causes LUTS. However, although chronic nonbacterial prostatitis with pelvic pain may sometimes be associated with urethral sphincter dysfunction, the cause of chronic nonbacterial prostatitis has not previously been shown to be estrogen dependent.
In men, obstruction of the urethra by benign prostatic hyperplasia (BPH), a benign enlargement of the prostate, is frequently considered to be the major cause of LUTS. However, several studies have shown that there is only a weak correlation between prostate enlargement, obstruction and LUTS.